1.Proficiency testing on determination of the content of geniposide in Gardeniae fructus by HPLC
Xiaohan GUO ; Yan CHANG ; Jiating ZHANG ; Kunzi YU ; Jianbo YANG ; Minghua LI ; Siyu MA ; Yiyun LU ; Xinhua XIANG ; Xianlong CHENG ; Feng WEI
Chinese Journal of Pharmacoepidemiology 2024;33(10):1115-1123
Objective To carry out a proficiency testing of content determination of geniposide in Gardeniae fructus,evaluate the content determination ability of index components in traditional Chinese medicine in the laboratory of inspection and detection in drug-related fields,and improve the quality control ability of content determination of related laboratories.Methods The laboratory's capability-verification activities were conducted based on the CNAS-RL02 Rules for Proficiency Testing and ISO/IEC 17043 Conformity Assessment-General Requirements for Proficiency Testing.After preparing the sample,the results of homogeneity and stability tests were analyzed according to CNAS-GL003 Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing.After the test results were qualified,they were used as proficiency testing samples and randomly distributed to participants.The results were collected,and the robust statistical method and the Z scores were used to analyze the results of these laboratories'reports.Results 403 laboratories in this proficiency testing program reported the results,of which 367 results were acceptable,accounting for 91.07%,17(4.22%)laboratories obtained suspicious results,and 19 laboratories gave unsatisfactory results,with the dissatisfaction rate of 4.71%.Conclusion The majority of the 403 participant laboratories have the ability to determine the content of geniposide in Gardeniae fructus by HPLC and the laboratory testing ability and quality management level of the drug monitoring system are high.This proficiency testing provides a basis for understanding the technical reserve capacity and management level of China's pharmaceutical inspection and testing laboratories,and provides technical support for future government supervision.
2.Establishing and evaluating of asthma rat model with phlegm and blood stasis syndrome
Xin YUAN ; Anqi WANG ; Siyu WANG ; Lexin PAN ; Jiaying WANG ; Lu ZOU ; Aidong YANG
Acta Laboratorium Animalis Scientia Sinica 2024;32(10):1243-1251
Objective To explore method of establishing and evaluating an asthma rat model with phlegm and blood stasis syndrome.Methods 60 SD male rats were randomly divided into 5 groups,a normal group,asthma group,combination of disease and syndrome(combination)group,DM group,and KCLW group,with 12 rats in each group.Asthma models were established using ovalbumin(OVA).A syndrome model of phlegm and blood stasis was established using a high-fat diet combined with the ice water bath method.We evaluated the asthma model through animal behavior observation,pathological section observation,inflammation index detection,and airway reactivity measurements.The phlegm and blood stasis syndrome model was evaluated via measurements of rat body mass,blood glucose,blood lipids,coagulation function,and hemorheological indexes and by observing symptoms and syndrome determination by Kechuan Liuwei mixture.Results(1)After OVA induction,the rats in the asthma model group and combination group showed symptoms such as shortness of breath,open mouth breathing,abdominal movement,restlessness,and irritability.HE staining showed the disordered arrangement of the bronchial mucosa in lung tissue,local detachment,thickening of the basement membrane and the bronchial tube wall,narrowing of the lumen,extensive infiltration of inflammatory cells,and congestion of capillaries.Compared with the normal group,the asthma model group and combination group(P<0.05)had increased serum IL-4,IL-6,and TGF-β1.Penh values were increased after stimulation with various concentrations of Mch(P<0.05).(2)Rats in the combination group showed symptoms such as chills,curling up with minimal movement,purple and dark claws,purple and black bruises on the tail,loose stools,and unclean perianal area.Compared with the rats in the asthma model group,rats in the combination group had increased body mass(P<0.05)and blood glucose,triglyceride,and total cholesterol levels(P<0.05),a shortened thrombin time(P<0.05),increased fibrinogen content(P<0.05),and significantly increased whole-blood viscosity at low,medium,and high shear rates(P<0.05).The indexes were significantly improved after Kechuan Liuwei mixture administration.Conclusions The asthma rat model with phlegm and blood stasis syndrome can be established through OVA induction and high-fat diet combined with ice water bath.The model can be evaluated through behavioral observation,index measurements,and syndrome determination via formulas.
3.Evaluation of the efficacy of platelet-rich fibrin membrane tamponade combined with silicone oil filling in high myopia macular hole with retinal detachment
Guojing LU ; Lei DU ; Siyu ZENG ; Yiqiao XING
Chinese Journal of Experimental Ophthalmology 2024;42(7):638-646
Objective:To investigate the role of platelet-rich fibrin (PRF) membrane tamponade combined with silicone oil filling in the treatment of high myopia macular hole (HMMH) with retinal detachment (RD).Methods:A randomized controlled study was conducted.A total of 52 patients (52 eyes) with HMMH with RD were enrolled at the Eye Center, Renmin Hospital of Wuhan University from September 2021 to April 2023.The patients were randomly divided into three groups according to the random number table method.All patients in the three groups underwent standard three-channel 23-gauge pars plana vitrectomy.In the internal limiting membrane (ILM) peeling group including 18 cases (18 eyes), the ILM was peeled intraoperatively.In the ILM tamponade group including 16 cases (16 eyes), the ILM flap was inverted and filled into the macular hole (MH).In the PRF tamponade group including 18 cases (18 eyes), the MH was filled with PRF.Intraocular pressure measurement, best corrected visual acuity (BCVA) measurement, and central macular thickness (CMT) measured by optical coherence tomography were performed preoperatively and 1 week, 1 month, 3 months, and 6 months postoperatively.Superficial retinal vessel density (SVD) and deep retinal vessel density (DVD) were determined by optical coherence tomography angiography before surgery and 6 months after surgery.The efficacy of the procedure was determined at six months postoperatively, and the rates of MH closure and retinal reattachment were compared among the three groups.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.2022-1-X-53).Written informed consent was obtained from each subject before any medical examination.Results:At 6 months postoperatively, the MH closure rates in the ILM peeling, ILM tamponade, and PRF tamponade groups were 83.3%(15/18), 87.5%(14/16), and 94.4%(17/18), respectively, without significant differences among them (fit χ2=1.180, P>0.05).Furthermore, the retinas of all groups were reattached.The postoperative BCVA of ILM peeling, ILM tamponade, and PRF tamponade groups were elevated compared with before surgery, and the differences were statistically significant (all at P<0.05).At 6 months after surgery, the CMT of the PRF tamponade group was significantly thicker than that of the ILM peeling and ILM tamponade groups (both at P<0.05).The CMT of the three groups at different time points after surgery was significantly decreased compared with before surgery, with statistically significant differences (all at P<0.05).SVD and DVD of the three groups at 6 months postoperatively were higher compared with before surgery, with statistically significant differences (all at P<0.05).No serious complications such as endophthalmitis and vitreous haemorrhage occured during treatment and follow-up.Müller cell gliosis was observed in 4 eyes in the ILM tamponade group, and no Müller cell gliosis eyes were seen in the remaining two groups. Conclusions:PRF tamponade combined with silicone oil filling can promote MH healing and retinal reattachment, improve visual acuity and blood flow density in patients suffering from HMMH with RD, and is a safe and effective surgical procedure.
4.Application of mesenchymal stem cell therapy in kidney transplantation: a continued story
Organ Transplantation 2024;15(3):398-405
Immunosuppressant is one of the main preventive measures for rejection after organ transplantation, whereas it may reduce the host response capability to pathogens and increase the risk of infection. In recent years, the application of mesenchymal stem cell (MSC) therapy in the field of solid organ transplantation has attracted widespread attention. Preclinical studies have shown that MSC therapy may prolong the survival time of transplant kidney, induce immune tolerance, accelerate the repair of acute kidney injury and promote the recovery of renal function. Clinical trials have confirmed the safety, tolerance and effectiveness of MSC therapy. Consequently, general characteristics, immunomodulation and tissue repair function of MSC, and the application of MSC in clinical trials of kidney transplantation were reviewed, the unresolved issues were briefly discussed and the prospects for subsequent research were predicted, aiming to provide reference for promoting the application of MSC therapy in clinical kidney transplantation.
5.Protective effect of 10-HDA on acute cadmium chloride-induced kidney damage and autophagy protein expression
Linwei LI ; Mingxuan HUANG ; Siyu LU ; Wenqi HUANG ; Yuan GONG ; Jie CHANG
Journal of Environmental and Occupational Medicine 2024;41(2):133-138
Background Acute cadmium (Cd) exposure can cause damage to multiple tissues, with the kidney being the primary target organ. The development of Cd-induced acute kidney injury involves complex mechanisms, in which autophagy and oxidative stress play crucial roles. Objective To investigate the effect of 10-hydroxy-2-decenoic acid (10-HDA) on kidney injury in mice exposed to cadmium, and provide experimental basis for studying the pathogenesis and prevention of Cd poisoning. Methods Thirty-five male C57BL/6 mice were divided into 7 groups (each of 5 mice): control group (normal saline, intraperitoneal injection), CdCl2 group (4 mg·kg−1, intraperitoneal injection), intervention groups ( 4 mg·kg−1 CdCl2, intraperitoneal Injection + 50, 100, 150, or 200 mg·kg−1 10-HDA, oral gavage), and 10-HDA group (150 mg·kg−1, oral gavage). All treatments were given for 14 d. Twenty-four hours after the last infection, physiological indicators [blood urea nitrogen (BUN), creatinine (CRE), malondialdehyde (MDA), and superoxide dismutase (SOD)], histopathological indicators, autophagy-related proteins (Atg7, Atg5, Beclin-1, and LC3), and mitochondrial autophagy-related proteins (PINK1 and Parkin) were detected to examine the effect of 10-HDA on kidney injury caused by CdCl2. Results Compared with the control group, the body weight of mice in the CdCl2 group was significantly reduced (P<0.01); compared with the CdCl2 group, the body weight of mice after intervention with different concentrations of 10-HDA was significantly increased (P<0.01). CdCl2 significantly increased BUN and CRE in the serum samples compared with the control group (P<0.01), which was significantly reduced to varying degrees after 100, 150, and 200 mg·kg−1 10-HDA intervention (P<0.01). MDA significantly increased and SOD significantly decreased in the renal cortex following CdCl2 administration compared with the control group (P<0.01), which was resolved following 10-HDA administration at different concentrations (P<0.01). In histopathological studies, 10-HDA restored injured kidney tissues induced by CdCl2. The expression levels of autophagy proteins Atg7 and LC3-II/I were significantly increased (P<0.05), and the expression level of Beclin-1 was significantly decreased (P<0.05) in the CdCl2 group compared with the control group. The expression levels of Atg7 were reduced to varying degrees after treatment with designed concentrations of 10-HDA, the expression levels of LC3-II/I were also reduced in the 50, 150, and 200 mg·kg−1 10-HDA intervention groups, and the expression levels of Beclin-1 were increased in the 50, 100, and 150 mg·kg−1 10-HDA intervention groups (P<0.05). The expression levels of PINK1 and Parkin in the CdCl2 group and the 50 mg·kg−1 10-HDA intervention group were lower than those in the control group (P<0.01). Compared with the CdCl2 group, the expression levels of PINK1 increased to varying degrees after 100, 150, and 200 mg·kg−1 10-HDA intervention, and the expression levels of Parkin increased in all 10-HDA intervention groups (P<0.01). Conclusion The intervention using 10-HDA can lessen acute kidney injury caused by CdCl2, reduce the expression of autophagy-related proteins, and increase the expression of mitochondrial autophagy-related proteins.
6.The Effect of Modified Shugan Dingji Decoction (疏肝定悸汤) on the Occurrence of Endpoint Events in Patients with Paroxysmal Atrial Fibrillation of Liver Constraint and Qi Stagnation: A Retrospective Cohort Study
Hainan LU ; Siyu QIAO ; Shuai ZHANG ; Yi ZHANG ; Lin SHEN
Journal of Traditional Chinese Medicine 2024;65(1):66-71
ObjectiveTo retrospectively analyze the effect of modified Shugan Dingji Decoction (疏肝定悸汤) on the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation. MethodsA retrospective cohort study was conducted using the electronic medical record database of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine to screen and include patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation from January 1st, 2018, to December 31th, 2021. The included patients were divided into an exposure group and a non-exposure group, each consisting of 100 cases, based on whether they received modified Shugan Dingji Decoction. General information of the patients including age, gender, body mass index, duration of illness and comorbidities, medication history, cardiac structure and function indicators such as left atrial diameter, left ventricular end-diastolic diameter, stroke volume and ejection fraction, and the occurrence of endpoint events assessed through 24-hour dynamic electrocardiography or electrocardiogram to determine the recurrence of paroxysmal atrial fibrillation were collected. Kaplan-Meier (K-M) curves and Log-Rank tests were used to conduct survival analysis on the occurrence of endpoint events in the two groups of patients. Univariate and multivariate Cox regression analyses were used to analyze the impact of various factors on entry into endpoint events. Additionally, a safety assessment was performed by comparing liver and kidney function indicators before and after treatment. ResultsIn the non-exposure group, a total of 49 cases (49.0%) experienced endpoint events, while in the exposure group, there were 26 cases (26.0%). The Log-rank test indicated significant difference between the two groups (χ2=11.211, P=0.001). Univariate Cox regression analysis showed that age, duration of illness, hypertension, diabetes, chronic heart failure, left atrial diameter, stroke volume, and the use of modified Shugan Dingji Decoction may be the influencing factors for the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation (P<0.05 or P<0.01). Multivariate Cox regression analysis showed that the risk of endpoint events in the exposure group was significantly lower than that in the non-exposure group (P<0.01). Patients with a duration of illness >12 months had a significantly higher risk of endpoint events compared to those with a duration of illness ≤12 months (P<0.01). Patients without concomitant hypertension had a lower risk of endpoint events compared to those with hypertension (P<0.05). Patients with left atrial diameter >40 mm had significantly higher risk of endpoint events than those with left atrial diameter ≤40 mm (P<0.01). There was no statistically significant difference in liver and kidney function indicators between the two groups before and after treatment (P>0.05). ConclusionThe use of modified Shugan Dingji Decoction is a protective factor for patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation, which can help to reduce the recurrence and progression of atrial fibrillation. Long duration of illness, concomitant hypertension, and enlarged left atrial diameter are risk factors for patients to experience endpoint events.
7.Patent analysis on Kampo Medicine in Japan based on PatSnap
Siyu DING ; Aijun CHENG ; Lu MA
International Journal of Traditional Chinese Medicine 2024;46(11):1412-1418
This study searched for Kampo Medicine patents on the PatSnap platform and analyzed them from five aspects: patent application trends, regional distribution, legal status, technical dimensions, and patent value. It has found that the patent awareness of Kampo Medicine companies started early and matured, based on local patent technology, while paying attention to overseas market layout and expanding the scope of protection; the core technology and competitiveness were concentrated in top enterprises; enterprises have attached great importance to cooperation with research institutes and universities. This article explored the development trend of Kampo Medicine patents through data analysis, in order to provide references for the cultivation and protection of high-value Chinese materia medica of relevant departments, TCM enterprises, and research institutions in China.
8.Two-sample Mendelian randomization analysis of causal relationship between eczema and autoimmune diseases
Chunli CHEN ; Siyu YAN ; Bangbei WAN ; Yangyiyi YU ; Jinrong ZENG ; Lina TAN ; Jianyun LU
Journal of Central South University(Medical Sciences) 2024;49(6):932-942
Objective:The causal relationship between eczema and autoimmune diseases has not been previously reported.This study aims to evaluate the causal relationship between eczema and autoimmune diseases. Methods:The two-sample Mendelian randomization(MR)method was used to assess the causal effect of eczema on autoimmune diseases.Summary data from the Genome-Wide Association Study Catalog(GWAS)were obtained from the Integrative Epidemiology Unit(IEU)database.For eczema and autoimmune diseases,genetic instrument variants(GIVs)were identified according to the significant difference(P<5×10-8).Causal effect estimates were generated using the inverse-variance weighted(IVW)method.MR Egger,maximum likelihood,MR-PRESSO,and MR-RAPS methods were used for alternative analyses.Sensitivity tests,including heterogeneity,horizontal pleiotropy,and leave-one-out analyses,were performed.Finally,reverse causality was assessed. Results:Genetic susceptibility to eczema was associated with an increased risk of Crohn's disease(OR=1.444,95%CI 1.199 to 1.738,P<0.001)and ulcerative colitis(OR=1.002,95%CI 1.001 to 1.003,P=0.002).However,no causal relationship was found for the other 6 autoimmune diseases,including systemic lupus erythematosus(SLE)(OR=0.932,P=0.401),bullous pemphigoid(BP)(OR=1.191,P=0.642),vitiligo(OR=1.000,P=0.327),multiple sclerosis(MS)(OR=1.000,P=0.965),ankylosing spondylitis(AS)(OR=1.001,P=0.121),rheumatoid arthritis(RA)(OR=1.000,P=0.460).Additionally,no reverse causal relationship was found between autoimmune diseases and eczema. Conclusion:Eczema is associated with an increased risk of Crohn's disease and ulcerative colitis.No causal relationship is found between eczema and SLE,MS,AS,RA,BP,or vitiligo.
9.Prevalence and clinical characteristics of atrial fibrillation in hospitalized patients with coronary artery disease and hypertension: a cross-sectional study from 2008 to 2018
Qian XIN ; Sijin ZHANG ; Chi WANG ; Siyu YAO ; Cuijuan YUN ; Yizhen SUN ; Ziwei HOU ; Miao WANG ; Maoxiang ZHAO ; Lu TIAN ; Yanjie LI ; Zekun FENG ; Hao XUE
Chinese Medical Journal 2023;136(5):588-595
Background::The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF.Methods::This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD.Results::The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age; to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2DS 2-VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions::AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.
10.Predictive value of MR myocardial strain in predicting recent adverse cardiovascular events after primary PCI in patients with acute ST-segment elevation myocardial infarction
Siyu PEI ; Hao MIAO ; Xin LIU ; Chengwen CHEN ; Yang DUAN ; Min ZHANG ; Yuan LU ; Wu XU ; Cheng WANG
Chinese Journal of Radiology 2023;57(8):897-903
Objective:To investigate the clinical application value of left ventricular myocardial strain obtained by cardiac MR (CMR) in recent major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Methods:From January 2020 to December 2020, a total of 163 patients successfully underwent primary PCI and underwent CMR examination within one week after surgery at Affiliated Hospital of Xuzhou Medical University. The scan sequences included rapid balance-fast field echo and late-gadolinium enhancement. CVI42 post-processing software was used to analyze and measure the left ventricular myocardial strain indices, including left ventricular global longitudinal strain (GLS), left ventricular global circumferential strain (GCS), and left ventricular global radial strain (GRS). According to the results of the 1-year follow-up after surgery, the patients were divided into the MACE group ( n=28) and the non-MACE group ( n=135). For continuous variables with a normal distribution, the t test of two independent samples was used for comparisons between groups. For continuous variables with an abnormal distribution, the variables were compared and analyzed by the rank sum test. For categorical variables, the χ 2 tests were used for between-group comparisons. Cox regression was used to analyze the prognostic value of myocardial strain on the development of MACE in patients with STEMI. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of myocardial strain parameters, and the optimal cut-off value was evaluated by calculating the Youden index. Results:The GLS, GCS, and GRS of the MACE group were (-10.4±3.3)%, [-11.9 (-14.5, -9.3)]%, and (18.3±6.3)%, respectively, and those of the non-MACE group were (-13.7±3.4)%, [-14.6 (-16.4, -11.7)]%, and (22.3±6.1)%, respectively. The difference between the two groups was statistically significant ( t/ Z=-4.71, -3.04, 3.21, P<0.05). Multivariate Cox regression analysis showed that GLS was an independent predictor of MACE (HR=1.546, 95%CI 1.180-2.027, P=0.002). The ROC curve analysis showed that GLS had the largest area under the curve (AUC) (AUC=0.754, 95%CI 0.658-0.851, P<0.001), with a cut-off value of -12.45%. Its diagnostic sensitivity was 71.4%, and the specificity was 67.4%. The value was better than that of the traditional predictor of STEMI prognosis, namely, left ventricular ejection fraction (AUC=0.680, 95%CI 0.567-0.793, P=0.003). Conclusion:GLS of CMR is an independent predictor of MACE in STEMI patients undergoing primary PCI.

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